Intrauterine Insemination (IUI)
- During a normal regular ovulatory cycle, one follicle develops per month from either ovaries.
- Ovum is released from the mature follicle after rupture. It travels through the patent fallopian tube.
- If intercourse happens at this time and semen parameters are normal, sperms travel through the uterus to reach ovum in tube and Fertilization takes place.
- Embryo formed travels back to the uterine cavity for implantation.
What is IUI?
- Intrauterine insemination (IUI) involves a laboratory procedure to separate rapidly moving sperms from sluggish or non-moving sperm.
- The rapidly motile sperms are then placed into the uterus close to the time of ovulation (release of an egg from the ovary) generally happens in the middle of the monthly cycle.
Who are eligible for IUI?
- Abnormal semen parameters like low sperm count or low motility.
- Absent sperm count ( Doner IUI).
- Male partner having difficulty in having a natural act of coitus (Impotence or ejaculatory problems).
- Ovulatory problems in the female partner like PCO (polycystic ovaries).
- A single parent wanting doner IUI.
Procedure of IUI For Women
Fertility drugs are used to stimulate ovulation.
- Transvaginal ultrasound is used to monitor the development of the eggs.
- When the egg reaches an adequate size, hormone injection (hCG) is given for egg release.
- The sperms are inserted 36 to 40 hours later.
- To do this, first, a speculum (a special instrument that keeps your vaginal walls apart) is inserted into the vagina.
- A small catheter (a soft, flexible tube) is then threaded into the uterus via the cervix. The best quality of sperm is selected and inserted through the catheter.
- The whole process takes just a few minutes and is usually painless.
- Rest in the supine position is given for 20 minutes at completion of the procedure after which woman can resume back to her routine life.
Husband is asked to produce a sperm sample on the day the treatment takes place.
The sperm is washed( confused ) to remove the fluid surrounding them and the fast-moving sperm separated out.
These separated fast moving sperms are instilled in the uterine cavity by small plastic tube (catheter).
FAQs of IUI :
1. Where is the sperm collected? How long before the IUI?
Usually, the sample is collected through ejaculation into a sterile collection container. The semen is to be delivered within a half hour of ejaculation, so if one lives close enough the sample can be collected at home. If not, one has to collect a sample in the clinic in a special room.
2. How much time the does procedure take?
There is a delay between when the semen sample is dropped off for washing and when it is inseminated. The amount of time depends on the washing technique used, which takes 1 to 2 hours.
3. When is the best timing for an IUI?
Ideally, an IUI is done within a few hours of the documentation of ovulation. When timing is based on an hCG injection, the IUIs are usually done between 36-42 hours post hCG trigger. Ideal timing would be to have a single IUI at about 36 hours post-hCG. If two IUIs are scheduled, they are usually done at 24 hours and 48 hours post hCG to cover the period of ovulation.
4. What is the success rate for IUI?
The success rate depends upon the development of one or multiple follicles and also upon sperm count and motility. Overall success rate seems to be 10-15percent per cycle.
5. What does an IUI feel like?
Most of the IUI is painless. Some women experience cramps due to procedure or ovulation.
6. How long does washed sperm live?
Current research indicates that washed sperm can live up to 72 hours also; however, it does lose fertility power to a certain extent after 24 hours.
7. Do I have to lay down after an IUI?
Post IUI 15-20 minutes rest is given after which you can resume your routine work.
8. How long before an IUI should the male abstain from intercourse/ejaculating and store up sperm?
Lesser abstinence period gives sperms with better motility and lesser DNA fragmentation.
9. How soon after an IUI can I have intercourse?
Intercourse can be resumed any time after IUI. Many times advise is given to have relations for 48 hours to cover ovulation.
10. How come I feel wetter after the IUI — like the sperm is falling out?
The catheter loosens cervical mucus and lets it come out more easily.
11. How many follicles give my best chance of getting pregnant?
Ovarian stimulation gives the development of more than one follicle 2-3 follicles give better results.
12. Does IUI make sense when there isn’t a sperm count problem?
IUI can help on stimulated cycles where cervical mucus is a problem, and IUI increases the chance of success on injectable cycles no matter what the sperm count. It does make sense to try IUI if you can and haven’t had success with intercourse.
13. How high a sperm count is needed for IUI?
The sperm count of 3-5millions after the wash is required for successful IUI.
14. Is bleeding common after an IUI?
It doesn’t usually happen. It is most common to have some bleeding if there is trouble reaching the cervix. Some women also have light bleeding with ovulation.
15. How many IUIs should I try before moving on to IVF?
Six IUI is advised with hormones before moving to IVF-ICSI however 3-4 IUI gives an idea about success with IUI.